Capitol Checkup: Medicare indication coverage; pre-existing conditions battle image

S&P Global Market Intelligence, September 4, 2018
Donna Young, quoting Rachel Sachs (Academic Fellow Alumna)

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"Allowing for indication-based coverage could result in some drugs not being available for some indications, but it could also result in drugs that aren't being covered now becoming available for higher-value uses," Coukell told S&P Global Market Intelligence.

But it is unclear whether those added drugs would make much of a difference to patients' lives, health policy expert Rachel Sachs, an associate professor of law at Washington University in St. Louis, told S&P Global Market Intelligence.

"I think there are a lot of unanswered questions," she said.

The two major lobbying groups representing brand-name drugmakers — the Pharmaceutical Research and Manufacturers of America and the Biotechnology Innovation Organization — said they were still reviewing the CMS memo.

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